上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

硫酸镁预防肺叶切除术后房颤的前瞻性队列研究

屈灿1，王小文2，黄春3，向小勇3，邱峰1，吕志前2   

  1. 1.重庆医科大学附属第一医院药剂科， 重庆 400016； 2.上海交通大学附属第六人民医院胸心外科， 上海 200233； 3.重庆医科大学附属第一医院胸心外科， 重庆 400016
  • 出版日期:2015-04-28 发布日期:2015-04-29
  • 作者简介:屈灿（1987—）， 女， 硕士生; 电子信箱: qcvivi2012@163.com。
  • 基金资助:

    重庆市卫生局医学科研计划重点项目（2011-1-026）

Prevention of atrial fibrillation after lobectomy by infusion of magnesium sulfate: a prospective cohort study

QU Can1, WANG Xiao-wen2, HUANG Chun3, XIANG Xiao-yong3, QIU Feng1, LÜ Zhi-qian2   

  1. 1.Department of Pharmacy, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China; 2.Department of Cardiothoracic Surgery, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai 200233, China; 3.Department of Cardiothoracic Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
  • Online:2015-04-28 Published:2015-04-29
  • Supported by:

    Key Project of Medical Science Research Program of Health Bureau of Chongqing, 2011-1-026

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摘要：

目的 评价围手术期预防性静脉应用硫酸镁对肺叶切除术后房颤（POAF）的有效性。方法 采用术前年龄和POAF危险因素配对的方法，将103例手术患者根据是否应用硫酸镁分为硫酸镁组（n=49）和对照组（n=54），硫酸镁组从术前3 d～术后3 d连续静脉应用25%硫酸镁2.5 g/d。观察的首要结局为POAF发生率，次要结局为有无不良反应以及其他并发症发生情况。结果 2组患者的临床资料比较差异无统计学意义，均衡性尚可；硫酸镁组POAF发生率低于对照组（6.1% vs 22.2%, P=0.026）；室上性心动过速和室性早搏也低于对照组，但差异无统计学意义。2组患者其他并发症发生率差异无统计学意义。结论 围手术期静脉应用硫酸镁可降低POAF的发生率。进一步验证和临床推广尚需要大规模的随机对照研究。

关键词: 房颤, 肺叶切除, 硫酸镁, 预防

Abstract:

Objective To evaluate the effectiveness of protective intravenous infusion of magnesium sulfate in perioperation on postoperative atrial fibrillation (POAF) after the lobectomy. Methods The method of matching the preoperative age and risk factors of POAF was adopted and 103 patients who underwent a scheduled lobectomy were divided into the magnesium sulfate group (n=49) and control group (n=54) according to whether magnesium sulfate was infused. Patients of the magnesium sulfate group were infused with 25% magnesium sulfate of 2.5 g/d for 3 d before and after surgery. The primary end point to be observed was the incidence of POAF and the secondary end point to be observed was the incidence of side effects and other complications. Results The differences of clinical data of two groups were not statistically significant. The incidence of POAF of the magnesium sulfate group was lower than that of the control group (6.1% vs 22.2%, P=0.026). The incidences of supraventricular tachycardia and ventricular premature beat of the magnesium sulfate group were also lower than those of the control group, but the differences were not statistically significant. The differences of other complications of two groups were not statistically significant. Conclusion Intravenous infusion of magnesium sulfate in perioperation can reduce the incidence of POAF. More randomized controlled studies are needed for further verification and clinical application.

Key words: atrial fibrillation, lobectomy, magnesium sulfate, prophylaxis